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Background: 40% of people with dementia have disturbed sleep but there are currently no known effective treatments. Studies of sleep hygiene and light therapy have not been powered to indicate feasibility and acceptability and have shown 40-50% retention. We tested the feasibility and acceptability of a six-session manualised evidence-based non-pharmacological therapy; Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS-START) for sleep disturbance in people with dementia. Methods: We conducted a parallel, two-armed, single-blind randomised trial and randomised 2:1 to intervention:Treatment as Usual. Eligible participants had dementia and sleep disturbances (scoring ≥4 on one Sleep Disorders Inventory item) and a family carer and were recruited from two London memory services and Join Dementia Research. Participants wore an actiwatch for two weeks prerandomisation. Trained, clinically supervised psychology graduates delivered DREAMS-START to carers randomised to intervention; covering Understanding sleep and dementia; Making a plan (incorporating actiwatch information, light exposure using a light box); Daytime activity and routine; Difficult night-time behaviours; Taking care of your own (carer’s) sleep; and What works? Strategies for the future. Carers kept their manual, light box and relaxation recordings post-intervention. Outcome assessment was masked to allocation. The co-primary outcomes were feasibility (≥50% eligible people consenting to the study): and acceptability (≥75% of intervention group attending ≥4 intervention sessions). Results: 63/95 (66%; 95% CI: 56-76%) eligible referrals consented between 04/08/2016 and 24/03/2017; 62 (65%; 95% CI: 55-75%) were randomised. 37/42 (88%; 95% CI: 75-96%) adhered to the intervention. Conclusions: DREAM.START for sleep disorders in dementia is feasible and acceptable. Funding: NIHR HTA 14/220/06

Type

Journal article

Journal

International Psychogeriatrics

Publisher

Cambridge University Press

Publication Date

18/04/2018